Doulas aren’t only for hippies, and they aren’t only for home births. These two doula myths have been busted in recent years as doula support itself has become increasingly popular.
Yet one doula myth has persisted: It’s what I like to call the “doula-as-savior” myth.
This is the idea that doulas can save pregnant people from a score of unwanted outcomes or treatment: Bad doctors. Bad midwives. Epidurals. Cesarean sections. Hospital births. Hospital staff. Bad home births. Bad birth experiences in general.
It's true that doula support is associated with some demonstrable benefits. In fact, according to a review of 23 different studies, continuous support during labor increases the chances of a spontaneous vaginal birth, has no harms and can enhance a woman’s satisfaction with her birth experience.
Yet these benefits do not make doulas saviors. They in no way guarantee that a doula can rescue a pregnant person from anything or anyone.
You may think that a doula is a roadblock between you and any birth intervention that you don't want. But sometimes no matter how much a doula does—no matter how many tricks they pull from their birth bags, no matter how many position changes they suggest—a c-section, or an induction, or a transfer from your home to the hospital might still become necessary. They cannot save you from it.
You might think that a doula can save you from the injustices of “the system”: of your hospital, your OB-GYN’s office and so on. Yet while a doula can help to facilitate communication between you and your care provider, they cannot save you from your care provider. Or your hospital. Or the nursing staff.
You might think that a doula can save you from a "bad" birth, full stop. But to make this assumption requires probing what it means for a birth to be “bad.” Is it one that leaves you feeling traumatized and disrespected? Or is it one that is associated with a specific, yet unpredictable outcome? If it's the latter, you might need to rethink your conception of what it means for a birth to be bad.
A doula cannot save you from any of the unexpected events that can occur during birth.
For a doula cannot save you from the pre-eclampsia that requires an induction or Cesarean section. A doula cannot save you from the hours of contractions that force you to change your mind and get an epidural after all. A doula cannot save you from any of the unexpected events that can occur during birth.
What if you reject the doula-as-savior myth, but the doula you interview seems to have this view of themselves?
If you can, it’s best to walk, not run, away from them.
They probably mean well. There are indeed injustices in the modern maternity care system. There are indeed care providers who don’t use cesareans, inductions or episiotomies judiciously. It is understandable that some doulas want to save people from those fates.
But a doula who views themselves as a savior risks projecting their own values and assumptions on their clients. They might push you to want what they want, instead of encouraging you to reflect on what you want for your birth.
Moreover, they might shift the locus of power away from you, and toward them. In doing so, they can perpetuate the myth of the fragile woman who needs to be rescued from a stronger, more powerful person.
Pregnant people are anything but fragile creatures in need of rescuing.
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So, what good are doulas if they can’t rescue you from a bad birth, a bad care provider or a bad birth experience in general?
They are companions. Comfort measure experts. Communication facilitators. Birth respecters.
They can suggest position changes and counterpressure techniques. They can teach your partner how to massage you during or in between contractions. They can help foster communication between you and your care providers. They can suggest questions that you can ask. They can help you articulate your birth preferences. They can even ask you questions to get you thinking about what exactly it is that you want.
And that’s precisely what any pregnant person deserves: Autonomy over their birth decisions. The opportunity to feel both powerful and vulnerable during their baby’s birth. The confidence that they will be surrounded by love and non-judgmental support as they bring their baby into the world.
You don’t absolutely need a doula to achieve any one of those goals. But a good doula will work alongside you to help you realize each one of them—without thinking of themselves as your savior.